Steroids can cause drug-induced diabetes, this was known over 50 years ago, but not fully understood.
Glucocorticoids is one of the types of steroid drug that has been shown to cause diabetes in a large number of people.
High-dose glucocorticoids for 2 to 3 months produces a high incidence of diabetes, usually with mild hyperglycemia occurring between the second and fourth week.
2% or more of all newly diagnosed cases of Type 2 Diabetes is due to people taking glucocorticoids and in people who already have diabetes it makes the symptoms worse.
This is often referred to as steroid diabetes or steroid-induced diabetes. In many cases if the person discontinues the steroids they will lose the symptoms of diabetes
Type 2 Diabetes, or diabetes mellitus, is a disease in which the body does not properly use insulin. For this reason, people with diabetes have high levels of glucose, which is a form of sugar, in their blood and in their urine.
The use of glucocorticoids can cause abnormalities in glucose levels. The drug tends to raise blood sugar levels when administered for 6 to 12 weeks. But as Tony Martin found out they can create diabetes really fast, he only took the glucocorticoid steroids when he really had to like when traveling abroad and not for very long and he ended up with Type 2 Diabetes.
According to Dr David Price, a diabetes expert at the Morriston Hospital, Swansea who said in the Daily Mail that in fact, steroid-induced diabetes is ‘very common’.
He went on to say that ‘Glucocorticoids are life-saving in many situations. But the unavoidable consequence is that they raise blood sugar.’
The drugs mimic the hormone cortisol, which is produced by the adrenal gland.
Cortisol is known for its anti-inflammatory effect, which is why these medications are prescribed for inflammatory conditions such as arthritis and asthma — but it also affects the way the body metabolises sugar.
‘Cortisol is a stress hormone,’ says Dr Price. ‘When you’re stressed, it acts to free up glucose from the liver because you need this energy to get to the muscles.’
As a result, blood sugar levels go up. And while many people on glucocorticoids see their blood sugars drop back to safe levels once they stop taking steroids, some, like Tony, develop full-blown diabetes, Dr Price explains.
‘In most people, their insulin will counteract these raised sugar levels,’ says Dr Price.
‘However, in some cases there may be a slight problem with insulin production anyway — this won’t have been an issue before.
‘But the steroids cause an added strain on the pancreas, causing the patient to become permanently diabetic.
‘It can depend on the dose you’re on, and underlying risks like whether you’re overweight and whether there’s a family history of diabetes,’ adds Dr Price.
‘When older people are put on a big dose of steroids, for example, a significant minority would become diabetic.
‘And if someone is already diabetic, they may go from being on tablets to having to inject themselves. Patients should be warned of the risks.’
Tony, however, had no family history of diabetes and was not overweight. He’d also had regular blood tests for years during routine medical checks, which he says had always been normal.
Glucocorticoids are used to help the body reduce inflammation. Doctors often prescribe it for things like asthma, pneumonia, cystic fibrosis, skin conditions and allergies. Glucocorticoids can be prescribed for days or even weeks at a time.
Taking glucocorticoids for a very short time might raise a person’s blood sugar levels, but not usually to a dangerous level.
Prolonged exposure to glucocorticoids may trigger the link between glucocorticoids and Type 2 Diabetes.
People who have to take glucocorticoids for a long time can run into problems as it raise glucose levels enough to cause diabetes or to cause serious problems for people who already have diabetes.
Cells inside a person’s body are deprived of energy and can starve if glucose levels rise and the glucose is not metabolized properly.
The link between glucocorticoids and diabetes can be controlled, however.
By carefully monitoring blood glucose levels, people who don’t have diabetes but are taking glucocorticoids can take precautions to help prevent themselves from getting the disease.
People on glucocorticoids who already have diabetes should be monitoring their blood sugar levels more closely than normal, watch their sugar intake and make sure not to get dehydrated while on the medication.
NOTE: Diabetes people should not take glucocorticoids without their doctor’s consent and supervision.
Steroid-induced diabetes is often reversible. The effects of the corticosteroid on the body’s glucose levels go away within a few days after the medication is stopped for most people. In this way, the connection between glucocorticoids and diabetes can be controlled for many people.
Below is a video on glucocorticoids (he talks fast for 11 seconds then slows down and stats to explain):